Having given birth among women with cerebral palsy: A Swedish population-based study

Cerebral palsy (CP) is a lifelong, early-onset disability characterized by heterogeneous functional impairments and comorbidities that may influence reproductive outcomes. Population-based evidence on having given birth among women with CP remains limited. We investigated differences in having given birth between women with CP and matched controls, and assessed the role of disability-related characteristics, comorbidities, sociodemographic, and contextual factors.

In this population-based study, 4832 women with CP aged 15-49 years during the study period (2010-2023) were compared with 24,018 age- and municipality-matched controls. Childbirth data from the Swedish Pregnancy Register were linked to national health and demographic registers. Logistic regression estimated odds ratios (ORs) with 95% confidence intervals (CIs).

Women with CP had substantially lower odds of having given birth during the study period than controls (OR 0.26, 95% CI 0.24-0.29). Among women with CP, lower odds were observed in those with spastic bilateral, dyskinetic, and ataxic CP, gross motor function corresponding to GMFCS IV-V, intellectual disability, and epilepsy. Associations with sociodemographic and contextual factors did not differ significantly between women with and without CP.

Women with CP were markedly less likely to have given birth during the study period, with substantial variation according to disability-related characteristics and comorbidities. Nevertheless, women across different disability-related profiles had given birth. These population-level findings highlight both the disparity between women with and without CP and the heterogeneity among women with CP and provide a basis for further research into reproductive opportunities, barriers, and support needs.